Active NPI
Erica R Shah, O.D.
- Optometrist
- Marietta, GA
National Provider Identifier
1518067925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV006985
- Practice address
- 3775 Roswell Rd Ste 150
Marietta, GA 30062-8821 - Phone
- (678) 321-2020
- NPI assigned
- Sep 25, 2006
- Last updated
- Oct 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV006985 | NY | Primary |
Addresses
Primary practice location
3775 Roswell Rd Ste 150
Marietta, GA 30062-8821
Mailing address
3775 Roswell Rd Ste 150
Marietta, GA 30062-8821
Phone (678) 321-2020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV006985 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Briggs Vision Group, P.C. | Optometrist | Past | Accepting new patients |
| State of New York Comptrollers Office | Optometrist | Past | Accepting new patients |
| Saltzman, Tanis, Pittell, Levin and Jacobson | Past | Accepting new patients | |
| State of New York Comptrollers Office | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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-
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- New York, NY
- NPI 1407829856
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- Developmental Disabilities Clinic/Center
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508198400000",
"number": "1518067925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3775 ROSWELL RD STE 150",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300628821",
"telephone_number": "678-321-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3775 ROSWELL RD STE 150",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300628821",
"telephone_number": "678-321-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "ERICA",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2017-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV006985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.